RAYMOND MAZZUCCO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000815

License Status

NOT RENEWED

Business

First Name

RAYMOND

Last Name

MAZZUCCO

Business Name

RAYMOND MAZZUCCO

Original Issue Date

08/06/1996

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

04/01/2010